“After controlling for several factors, we saw the risk rose in tandem with the more doses that people consumed. The mortality hazard was very high, and even surprised us… More research is needed to know exactly why sleeping pills are causing early death, but we believe the risks of taking sleeping pills outweigh the benefits.”
~ Dr. Daniel Kripke, Viterbi Family Sleep Center
One of the most frequently-cited issues for people in early recovery is insomnia and poor sleep. This is a serious problem, because if not corrected, it could even jeopardize their sobriety.
Insomnia Can Cause a Relapse
The ability to achieve regular, quality sleep has been shown to be a very accurate predictor of relapse. In 1998, one study found that over half of all alcoholics in recovery who had untreated sleep disturbances experience a relapse within five months.
Self-Medicating – a Dangerous Misconception
Far more than the rest of the general population, people with substance abuse disorders must be extra careful with any medications they take to help them sleep. They especially need to stay away from risky self-medicating. Over 60% of alcoholics in treatment think that drinking will help them sleep.
Most Sleep Medications Are Counterproductive to Sobriety
The majority of prescription sleep medications are extremely risky for people in recovery, because those medications also carry a high potential for addiction:
- A person prescribed benzodiazepine tranquilizers can develop a dependency in as little as two weeks.
- Withdrawal from benzodiazepine dependency has the potential to be fatal.
- Non-benzodiazepine sleep medications such as Lunesta or Ambien can cause a person’s risk of clinical depression to double.
- This is significant, because up to 50% of people with Alcohol Use Disorders (AUDs) will exhibit symptoms of a major depressive disorder within their lifetime.
- According to the British Medical Journal, prescription sleep medications may be linked to shorter lifespans.
Even over-by-counters are generally ineffective for long-term insomnia lasting longer than a month. Most also contain antihistamines, which can lead to prolonged drowsiness that may last into the following day.
Medications That Are Safe During Recovery from Addiction
Depending on the individual’s history of addiction or medical/psychiatric problems, a physician may be able to prescribe certain medications with a low potential for abuse or dependence. Trazodone is an antidepressant that also has sedative properties, and it has been used successfully for many years to help newly-sober substance abusers with their sleep problems.
How Big Is the Problem of Sleep Disturbances among People in Recovery, REALLY?
The rates of insomnia or poor sleep quality among people in recovery for an addictive disorder are much higher than the rest of the population:
- Among patients with insomnia, 55% report that they “frequently” drink alcohol to help them sleep.
- The rate among patients without insomnia is 28%.
- Within five months after completing substance abuse treatment, 60% of those patients who suffered with insomnia relapsed.
- For patients without insomnia, the relapse rate during that same timeframe drops to 30%.
- Two-thirds of people with an AUD have insomnia to some degree.
- The rate of insomnia for the general population is no more than 30%.
The problem is much greater for people who are new to recovery and may still be experiencing lingering withdrawal symptoms – after just one week of abstinence, 91% of alcoholics in residential treatment meet the criteria for a sleep disturbance clinical diagnosis.
Is There Anything That Can Be Done to Help Alleviate Sleep Disturbances during Addiction Recovery?
Fortunately, there are several strategies that are proving effective at easing the burden felt by substance abusers suffering from insomnia and other sleep problems.
Many forms of cognitive behavioral therapy (CBT) are effective for up to 80% of insomnia patients. CBT treatment for sleep disturbances usually involves between six and eight individual/group therapy sessions. One of the components of this strategy is sleep hygiene education.
Although education by itself is not overly effective as a means of treating long-term sleep disturbances, it remains an important facet of integrated insomnia treatment.
A patient learning about sleep hygiene will find out how to substitute or change behaviors that may be contributing to their lack of quality sleep.
Tips from CBT That Can Help Recovering Substance Abusers Sleep Better
- DO NOT take naps during the daytime
- Reduce or eliminate caffeine intake
- Quit smoking
- Establish a regular routine for meals, bedtime, etc.
- Create the ideal environment for sleeping
- If you take sleep medications, give them time to work before going to bed
- DO NOT go to bed unless you are very sleepy
- DO NOT exercise just before bedtime
- Remove disturbances – no TV, reading, or eating in bed
- Get up if you are just lying there awake
Do Not Ignore the Benefits of Therapy for Sleep Disturbances during Recovery
Because it is such a widespread problem, most premier rehab programs will incorporate various therapies designed to help you get better-quality sleep.
- Cognitive Therapy – Works on helping the patient change any counter-productive believes they may hold about their sleeping problems. This reduces their anxiety and stress – both of which contribute to insomnia – by allowing them to have more realistic expectations.
For example, once a person understands that occasional sleeping difficulties are NORMAL and TEMPORARY, it may ease some of their anguish that is, ironically, interfering with their sleep pattern.
- Relaxation Therapy – The patient learns how to reduce their mental or physical education by employing a number of techniques:
- Progressive muscle relaxation
- Thought stopping
Yoga as an Antidote for Poor Sleep
A study conducted by the Harvard Medical School revealed that practicing yoga during recovery from addiction may result in:
- Better-quality sleep
- Decreased fatigue
- Less need for prescription sleep medicine
- Shortened time needed to fall asleep
- More total sleep time
Yoga is so effective that these benefits they manifest even when yoga is practiced as little as two sessions per week.
There is Hope for Sleep-Deprived People in Recovery
The lack of enough quality sleep during recovery can make a newly-sober individual feel confused, lethargic, and so absolutely miserable that they risk relapse.
But working with an experienced addiction counselor can be one way to address the issue of disrupted sleep. The techniques and skills taught in recovery are learnable, so the newly-sober addict can affect a positive change while the rest of their body is readjusting to life without alcohol or drugs.